We are hiring a Director of Payer Contracting & Strategy to own and lead our national payer contracting and managed care strategy across commercial, Medicare Advantage, and Medicaid health plans.
This is a leadership role for a proven payer expert who understands how payers assess risk, structure reimbursement models, and operationalize complex managed care contracts in dynamic, multi-state healthcare environments.
The Director will own the end-to-end payer lifecycle, including payer strategy, contract development and negotiation, reimbursement optimization, and scalable payer operations. This role partners closely with executive leadership and cross-functional teams to support market expansion, value-based care initiatives, and sustainable reimbursement economics.
Own the full payer contracting lifecycle: Lead payer engagement from strategy and outreach through contract submission, negotiation, redlining, execution, renewals, and ongoing relationship management.
Expand national payer relationships: Leverage deep existing relationships to grow partnerships with commercial, Medicare Advantage, and Medicaid payers across multiple markets.
Lead payer strategy and reimbursement optimization: Design and execute payer strategies that align reimbursement models, operational workflows, and financial performance.
Support new market expansion: Drive payer contracting for new states and markets, working with local, regional, and national health plans.
Build scalable contracting infrastructure: Develop repeatable systems and processes across payer contracting, credentialing coordination, roster management, compliance, and performance tracking.
Cross-functional leadership: Partner with executive leadership, general managers, credentialing, revenue cycle, and operations teams to translate payer requirements into operational execution.
Serve as the internal payer authority: Advise leadership on payer policy, regulatory changes, reimbursement trends, and managed care best practices.
People leadership: Build, develop, and lead a high-performing payer contracting and managed care team as the organization scales.
7+ years of healthcare experience within payer organizations, risk-bearing providers (IPA/MSO), managed care organizations, institutional providers, home health, hospice, or health technology companies.
5+ years of direct payer contracting and/or credentialing leadership experience, with a strong track record negotiating managed care and primary care contracts.
Established payer relationships and credibility across the managed care ecosystem.
Deep understanding of reimbursement models, payment methodologies, value-based care, and medical group economics.
Working knowledge of revenue cycle management (RCM), claims, and payer operations to ensure contracts are operationally executable.
Experience building or scaling a payer relations or contracting function in a high-growth or tech-enabled healthcare environment.
Strong executive communication skills; comfortable presenting to senior leadership.
Proficiency with MS Office, CRMs, databases, and contract management tools.
Experience in a healthcare startup or growth-stage organization.
Proven ability to define KPIs, establish operating cadence, and drive measurable outcomes.
Preference for candidates based in Southern California (open to remote).
Ability to travel periodically to Southern California headquarters and partner sites.